| Epidural injection, lumbar/sacral (with imaging) (62322) |
$936.20 |
$4,681 |
1.1× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$849 |
$4,245 |
1.0× |
| CT head/brain without contrast (70450) |
$817.20 |
$4,086 |
8.1× |
| MRI brain without contrast (70551) |
$907.80 |
$4,539 |
4.0× |
| MRI brain with contrast (70552) |
$1,406 |
$7,030 |
4.2× |
| MRI brain without and with contrast (70553) |
$1,406 |
$7,030 |
4.2× |
| X-ray lower spine, 4+ views (72110) |
$426.60 |
$2,133 |
4.2× |
| MRI lumbar spine without contrast (72148) |
$998.40 |
$4,992 |
4.4× |
| CT pelvis with contrast (72193) |
$920.40 |
$4,602 |
5.5× |
| MRI lower-extremity joint without contrast (73721) |
$998.40 |
$4,992 |
4.4× |
| CT abdomen and pelvis with contrast (74177) |
$2,380.60 |
$11,903 |
7.1× |
| Ultrasound, abdomen complete (76700) |
$1,069 |
$5,345 |
10.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$278 |
$1,390 |
2.8× |
| Ultrasound, transvaginal (76830) |
$278 |
$1,390 |
2.8× |
| Mammography, one breast (diagnostic) (77065) |
$171.40 |
$857 |
2.0× |
| Mammography, both breasts (diagnostic) (77066) |
$212.40 |
$1,062 |
1.9× |
| Mammography, screening (bilateral) (77067) |
$143.60 |
$718 |
1.6× |
| Basic metabolic panel (80048) |
$145.80 |
$729 |
17.2× |
| Comprehensive metabolic panel (80053) |
$162.80 |
$814 |
15.4× |
| Obstetric panel (80055) |
$73.60 |
$368 |
1.5× |
| Lipid panel (80061) |
$120.20 |
$601 |
9.0× |
| Renal function panel (80069) |
$260.80 |
$1,304 |
30.0× |
| Hepatic function panel (80076) |
$270.20 |
$1,351 |
33.1× |
| Urinalysis, non-automated, with microscopy (81000) |
$11.80 |
$59 |
2.9× |
| Urinalysis, non-automated, without microscopy (81002) |
$17.80 |
$89 |
5.1× |
| PSA, total (84153) |
$70.60 |
$353 |
3.8× |
| Thyroid stimulating hormone (TSH) (84443) |
$186.40 |
$932 |
11.1× |
| CBC with automated differential (85025) |
$149.80 |
$749 |
19.3× |
| CBC, automated (85027) |
$109.40 |
$547 |
16.9× |
| Prothrombin time (PT) (85610) |
$75 |
$375 |
17.5× |
| Partial thromboplastin time (PTT) (85730) |
$35 |
$175 |
5.8× |
| Sleep study (attended polysomnography) (95810) |
$2,086.60 |
$10,433 |
2.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$73 |
$365 |
2.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$195.40 |
$977 |
1.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$237 |
$1,185 |
1.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$237 |
$1,185 |
1.9× |